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Verma M, Aditi A, Kapoor N, Sharma P, Kakkar M, Kakkar R, Kalra S. Childhood Obesity and Essential Micronutrients: Insights from India's Comprehensive National Nutrition Survey (2016-18). Diabetes Ther 2023:10.1007/s13300-023-01424-2. [PMID: 37264296 PMCID: PMC10299976 DOI: 10.1007/s13300-023-01424-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 05/11/2023] [Indexed: 06/03/2023] Open
Abstract
INTRODUCTION Based on the long-term impact of childhood obesity, there is a compelling need to assess the burden of obesity and micronutrient deficiency and the interactions between the two. Thus, the aims of the study were to estimate the prevalence of overweight and obese children and adolescents to compare micro-nutrient levels in these children with normal and underweight categories and explore the factors affecting overweight and obesity in the presence of micronutrient deficiencies. METHODS Secondary data analysis of the Comprehensive National Nutrition Survey-India (2017-2018) was done. The survey recorded information from 112,245 preschool children (6-60 months), school age children (5-9 years), and adolescents (10-19 years). Half of these participants were invited for biochemical testing and were included in our analysis. The presence of overweight or obesity and micronutrient (serum erythrocyte folate; vitamin B12, A, and D; ferritin; zinc; and urinary iodine) deficiencies were the primary outcomes. The secondary outcome included the mean serum levels and predictors of overweight and obesity in the presence of micronutrient deficiencies. RESULTS Of the 38,060, 38,355, and 35,830 preschool, school-age, and adolescent study participants, about 2.69, 4.18, and 4.99% were overweight or obese. We observed significant variations in the mean folate and vitamin B12 levels among the overweight and obese preschool and school-age children compared to the normal weight group. School-age children exhibited significant differences in all micronutrient levels. In contrast, adolescents only showed substantial differences in vitamin D and A and serum ferritin levels. The predictors of overweight and obesity included geographical locations, wealth quintiles, and societal castes. Iron, folate, vitamin D, and zinc levels significantly affect the odds of developing childhood overweight and obesity. CONCLUSIONS It is vital to halt the growing burden of childhood overweight and obesity. Addressing micronutrient deficiencies can help us bring a sustainable and feasible approach to managing this menace.
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Affiliation(s)
- Madhur Verma
- Department of Community and Family Medicine, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India.
| | - Aditi Aditi
- International Institute for Population Sciences (IIPS), Mumbai, Maharashtra, 400088, India
| | - Nitin Kapoor
- Department of Endocrine, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, 632004, India
- Non-Communicable Disease Unit, The Baker Heart and Diabetes Institute, Melbourne, VIC, 3004, Australia
| | - Priyanka Sharma
- Department of Preventive Oncology, MPMMCC, and HBCH, TMC, Varanasi, Uttar Pradesh, India
| | - Monica Kakkar
- Department of Biochemistry, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, 151001, India
| | - Rakesh Kakkar
- Department of Community and Family Medicine, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India.
- University Centre for Research and Development, Chandigarh University, Mohali, Punjab, India.
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Khadilkar AV, Lohiya N, Mistry S, Chiplonkar S, Khadilkar V, Kajale N, Ekbote V, Vispute S, Mandlik R, Prasad H, Singh N, Agarwal S, Palande S, Ladkat D. Random Blood Glucose Concentrations and their Association with Body Mass Index in Indian School Children. Indian J Endocrinol Metab 2019; 23:529-535. [PMID: 31803592 PMCID: PMC6873251 DOI: 10.4103/ijem.ijem_536_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE AND AIMS Overweight/obese children are at risk of developing type 2 diabetes mellitus. Random glucose elevations provide early warning signs of glycemic dysregulation. To assess random blood glucose (RBG) concentrations and risk factors associated with prediabetes in children aged 3-18 years from six Indian regions. METHOD Multicenter, cross sectional, observational school-based study; multi-stage stratified random sampling was carried out. Height and weight measured; body mass index (BMI) was computed. RBG measured using a glucometer. National sample survey was used for dietary patterns. Data were analyzed using SPSS 25.0 for Windows. SETTING Study centers were from Maharashtra, Gujarat, Chhattisgarh, Assam, Tamil Nadu and Punjab from 40 selected schools. PARTICIPANT Children aged 3-18 years were measured. RESULTS Data on 14339 subjects (7413 boys) were analyzed. Prevalence of obesity was 5.8% and overweight-10.6%. Overall, 1% had low (<3 mmol/L), 93.7% in reference range (3.9-7.2 mmol/L) and 5.3% had elevated RBG (>7.2 mmol/L). With increasing mean BMI, there was increase in RBG concentrations. Children from Tamil Nadu were more likely to have RBG outside reference range compared to other regions (P < 0.05). Assam and Punjab had highest prevalence of RBG and BMI within reference range. Energy intake partly explained regional variations. Multivariate analysis showed male gender, urban residency, age >10 yrs (girls) and 13 yrs (boys), and overweight or obesity were predictive of prediabetes. CONCLUSION Increased prevalence of overweight, obesity and prediabetes in Indian children are a matter of concern. Regional differences suggest that strategies to prevent obesity and combat perturbations in blood sugar may have to be customized.
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Affiliation(s)
- Anuradha V. Khadilkar
- Department of Paediatric and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, Maharashtra, India
| | - Nikhil Lohiya
- Department of Paediatric and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, Maharashtra, India
| | - Sejal Mistry
- Department of Paediatric and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, Maharashtra, India
| | - Shashi Chiplonkar
- Department of Paediatric and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, Maharashtra, India
| | - Vaman Khadilkar
- Department of Paediatric and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, Maharashtra, India
| | - Neha Kajale
- Department of Paediatric and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, Maharashtra, India
| | - Veena Ekbote
- Department of Paediatric and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, Maharashtra, India
| | - Smruti Vispute
- Department of Paediatric and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, Maharashtra, India
| | - Rubina Mandlik
- Department of Paediatric and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, Maharashtra, India
| | - Hemchand Prasad
- Department of Paediatric Endocrinology, Dr Mehta's Hospital Pvt Ltd, Chennai, Tamil Nadu, India
| | - Narendra Singh
- Department of Anthropology, Assam University, Diphu, Assam, India
| | - Sanwar Agarwal
- Department of Paediatric Endocrinology, Ekta Institute of Child Health, Raipur, India
| | - Sonal Palande
- Department of Paediatric and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, Maharashtra, India
| | - Dipali Ladkat
- Department of Paediatric and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospitals, Pune, Maharashtra, India
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Gregori D, Hochdorn A, Azzolina D, Berchialla P, Lorenzoni G. Does Love Really Make Mothers Blind? A Large Transcontinental Study on Mothers' Awareness About Their Children's Weight. Obesity (Silver Spring) 2018; 26:1211-1224. [PMID: 29932519 DOI: 10.1002/oby.22214] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 04/23/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The aim of this study was to assess maternal misperception rates (perception as normal or underweight of a child with overweight or obesity) and their role in affecting the chance of implementing actions to change children's weight. METHODS Obesogeneicity of Gadgets Marketed with Snacks (OBEY-AD) is an international study investigating factors promoting childhood overweight and obesity in 10 countries, in which 2,720 child-mother dyads have been enrolled. Mothers' perception of their children's weight was assessed using a projective test. Children's weight status was measured according to the anthropometric standards established by the World Health Organization. RESULTS Mothers classified 89% of children with overweight and 52% of children with obesity as normal weight. The odds ratio of mothers' misperception was significantly higher for higher parental BMI, higher children's International Brand Awareness Inventory score, and high family socioeconomic status. Children with overweight and/or obesity who were perceived as normal weight by their mothers were less likely to be referred to specific health care services. CONCLUSIONS Most children with overweight and/or obesity were perceived as normal weight by their mothers. Such lack of concern regarding a severe disease might interfere with the effectiveness of prevention programs. Considering the contextual factors that frame the etiological causes of a disease may help in finding effective and enduring solutions to target childhood obesity.
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Affiliation(s)
- Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy
| | - Alexander Hochdorn
- Department of Social, Work and Organisational Psychology, University of Brasília, Brasília, Brazil
| | - Danila Azzolina
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy
| | - Paola Berchialla
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy
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Lorenzoni G, Rtskhladze IL, Azzolina D, Manza E, Soriani N, Gregori D. How different is the country of Georgia in developing obesity? An international comparison from the OBEY-AD database. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2017. [DOI: 10.3233/mnm-17154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy
| | | | - Danila Azzolina
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy
| | - Emiliano Manza
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy
| | - Nicola Soriani
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy
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